Burst fractures result from severe axial compression such as may occur if a heavy object fell on the head or in diving accidents. In the most severe cases the vertebral body literally bursts and bone fragments may be driven backwards into the spinal canal causing spinal cord damage.
A burst fracture of C1 (atlas) is known as a 'Jefferson Fracture'. About 50% of patients survive this injury without neurological deficit because the majority of the mass of the atlas is in the two lateral masses which displace sideways away from the spinal canal.
Displaced fractures are treated with skull traction for six to eight weeks followed by a plastic collar until interbody fusion is seen on X-ray.
Undisplaced fractures are treated with a halo-body cast or in less severe cases a cervical brace.
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